Dataset Information

Differences in sepsis treatment and outcomes between public and private hospitals in Brazil: a multicenter observational study.

ABSTRACT:

Background

Previous studies showed higher sepsis mortality rates in Brazil compared to other developed or developing countries. Moreover, another trial demonstrated an increased mortality rate in public hospitals compared to private hospitals in Brazil. The reasons for these findings may include delayed recognition and inadequate treatment of sepsis in public facilities. We designed this study to evaluate the factors associated with mortality in septic patients admitted to intensive care units in a network of public and private institutions.

Materials and methods

This study is a retrospective analysis of a prospective cohort of sepsis patients in 19 private and public institutions in Brazil. We analyzed data from the original database and collected additional data to assess compliance to the treatment guidelines and to determine the time from the onset of organ dysfunction and the sepsis diagnosis by the healthcare team.

Results

A total of 396 patients were analyzed. Patients in public hospitals were younger, had a greater number of dysfunctional organs at baseline and a lower chance to have sepsis diagnosed within two hours of the onset of organ dysfunction. Private hospitals had a better compliance to lactate and blood culture sampling and maintenance of glycemic control. The multivariate analysis showed that age, disease severity at baseline and being treated at a public hospital were independent risk factors for mortality. A delay in the sepsis diagnosis of longer than two hours was associated with mortality only in the public setting.

Conclusions

We confirmed a lower sepsis mortality rate in the private hospitals of this network. Being treated in a public hospital was an independent factor for mortality. Delayed recognition of sepsis was more frequent in public institutions and this might have been associated with a higher mortality. Improving sepsis recognition and early diagnosis may be important targets in public institutions.

SUBMITTER: Conde KA

PROVIDER: S-EPMC3675193 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Differences in sepsis treatment and outcomes between public and private hospitals in Brazil: a multicenter observational study.

Conde Katia Aparecida Pessoa KA Silva Eliezer E Silva Carla Oliveira CO Ferreira Elaine E Freitas Flavio Geraldo Rezende FG Castro Isac I Rea-Neto Alvaro A Grion Cintia Magalhaes Carvalho CM Moura Anselmo Dornas AD Lobo Suzana Margareth SM Azevedo Luciano Cesar Pontes LC Machado Flavia Ribeiro FR

PloS one 20130606 6

<h4>Background</h4>Previous studies showed higher sepsis mortality rates in Brazil compared to other developed or developing countries. Moreover, another trial demonstrated an increased mortality rate in public hospitals compared to private hospitals in Brazil. The reasons for these findings may include delayed recognition and inadequate treatment of sepsis in public facilities. We designed this study to evaluate the factors associated with mortality in septic patients admitted to intensive care ...[more]

PMID: 23762255

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Dataset Information

Differences in sepsis treatment and outcomes between public and private hospitals in Brazil: a multicenter observational study.

Background

Materials and methods

Results

Conclusions

Publications

Differences in sepsis treatment and outcomes between public and private hospitals in Brazil: a multicenter observational study.

Similar Datasets

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